胆囊结石与胆囊收缩素受体(CCK-A)和血管活性肠肽(VIP)的关系研究

On the relationship between gallstones and cholecystokinin-A receptor and vasoactive intestinal poly-peptide

目的探讨胆囊动力学异常在胆囊结石形成中的作用。方法随意选择胆囊结石患者35例,胆囊息肉样病变患者25例,正常对照30例。B超测空腹胆囊容积。放射免疫法测定血浆中血管活性肠肽(VIP)的浓度,逆转录-聚合酶链反应(rt-PCR)法测胆囊黏膜中胆囊收缩素(CCK-A)受体表达数目。结果①胆囊结石组胆囊空腹体积明显大于其它两组(F=3.45,P=0.039);②胆囊结石组胆囊收缩率明显低于其它两组(F=5.747,P=0.005);③三组之间餐后VIP升高量无明显差异(F=0.768,P=0.47);④胆囊结石组胆囊收缩素(CCK-A)受体表达明显低于胆囊息肉样病变组(t′=4.390,P=0.022),差异具有显著性。结论①胆囊结石组空腹胆囊体积增大与其胆囊结石形成有关;②胆囊结石组胆囊收缩功能下降导致结石形成;③胆囊收缩素(CCK-A)受体表达低,使胆囊收缩功能减弱,促进胆囊结石的形成;④血管活性肠肽(VIP)与胆囊结石的形成无明显关系。

Objective To discuss the effect of abnormal biliary dynamics on the formation of cholelithiasis. Methods A total of 35 cases of gallstone （ Gallstone Group） , 25 cases of gallbladder polypoid lesions （ Polypus Group） , and 30 normal cases （Control Group） were included in this study. The fasting gallbladder volume was measured with B - uhrasonography, the serum concentration of vasoactive intestinal poly - peptide （VIP） was determined with radioimmunoassay, and the expression of cholecystokinin -A （CCK -A） receptor in the gallbladder mucous membrane was detected with reverse transcriptase polymerase chain reactions （ rt - PCR）. Results （1）The fasting gallbladder volume was significantly greater in the Gallstone Group than in the other two groups （ F = 3.45, P = 0. 039）. （2）The gallbladder contraction rate was significantly lower in the Gallstone Group than in the other two groups （ F = 5. 747, P = 0. 005 ）. （3）The postprandial increases of VIP of the three groups were not of statistical significance （ F = 0. 768, P = 0.47）. （4）Compared with the Polypus Group, the expression of CCK - A receptor in the Gallstone Group was significantly decreased （t＇ =4. 390, P = 0. 022）. Conclusions （1） The increase of the fasting gallbladder volume in the Gallstone Group is associated with the formation of gallstones. （2）In the Gallstone Group, depressed gallbladder contraction results in the formation of gallstones. （3）The decreased expression of CCK - A receptor leads to depressed gallbladder contraction, which facilitates the formation of gallstones. （4）Serum VIP is not related to the formation of gallstones.